| ObjectiveAs one of the important hub cities in North-east area in China,Shenyang has the characteristics of serious air pollution and complex pollution sources.It is of great significance to explore the air pollution in this region,its health hazards to the health for population protection.This study aims to provide a theoretical basis for the study of the health effects of atmospheric PM10 and PM2.5 by exploring the short-term effects of atmospheric PM10 and PM2.5 on the hospital admission of respiratory diseases in Shenyang.MethodsData from 2015 to 2017 of meteorological factors,atmospheric pollutant concentrations in Shenyang,and the inpatient of the respiratory department affiliated to the Central Hospital of Shenyang Medical College were collected,and a database was established after logical correction.Daily average temperature,humidity,sea level pressure,wind speed were included in meteorological data;atmospheric PM2.5,PM10,SO2,NO2,O3,CO daily average concentration and AQl,daily major pollutants were included in atmospheric pollutant data;baseline data,hospitalization dates,disease diagnosis,comorbidities,smoking and alcohol status were included in hospital admission data.The statistical descriptive analysis method was used to describe the atmospheric pollutants,meteorological data and patient data,and the correlation analysis between atmospheric pollutants and meteorological data was carried out by Spearman correlation.1:2 time-stratified case-crossover with self-control,conditional logistic regression were used to explore the optimal lag effect and multi-pollutant effect of atmospheric pollutants on hospital admission of residents’ respiratory diseases,and the characteristics of the population and heating situation were analyzed hierarchically to control the effects of confounding factors.Results1.The median(interquartile range)of atmospheric PM2.5 in Tiexi District is 46μg/m3(45.25μg/m3),and PM10 is 86μg/m3(69μg/m3)during 2015 to 2017,which is higher than the overall air pollution level in Shenyang,and the concentration has been decreasing year by year since 2015.2.Among the six pollutants in Tiexi District of Shenyang,atmospheric PM2.5 and PM10 are the main pollutants.There were 588 days with atmospheric PM2.5 as the primary pollutant,accounting for 53.6%of the total days,and 429 days with atmospheric PM10 as the primary pollutant,accounting for 39.1%.The atmospheric PM2.5 national level exceeded the second-level for 277 days,and the over-standard rate is 25.27%;the atmospheric PM10 national level exceeds the second-level for 185 days and the over-standard rate is 16.88%.3.In 2015,pollution days of the heating,non-heating and annual period accounted for 66.23%,20.56%and 39.45%respectively;in 2016,pollution days of the heating,non-heating and annual period accounted for 43.42%,11.68%and 24.86%respectively;in 2017,pollution days of the heating,non-heating and annual period accounted for 41.72%,12.15%,24.38%.In 2015-2017,the proportion of pollution days in the heating period,non-heating period and three years was 50.66%,14.80%and 29.63%respectively.The proportion of pollution days in the heating period during 2015,2016,2017 and all the three years was higher than that in the non-heating period,and the difference was statistically significant(P<0.05).In addition,the number of pollution days in the heating period in 2015 was higher than other years.4.A total of 6626 patients in the Department of Respiratory Medicine of the Affiliated Central Hospital of Shenyang Medical College were collected.The median number of participants(interquartile range)was 6(4),and the minimum number of hospital admissions was 0 and the maximum number was 17.During the heating period during 2015 to 2017,the monthly average number of admissions for respiratory diseases was higher than that of non-heating period.The number of hospital admissions during the heating period in 2015 and 2016 was higher than that in the non-heating period,but in 2017.no significant differences were seen.5.During 2015 to 2017,the changes of atmospheric PM2.5,PM10 concentration and daily number of admission to the respiratory system increased during January to March and September to December;decreased during April to August and was obvious seasonal periodicity,and winter and spring were higher than summer and autumn.6.During the study period,the number of people admitted to the hospital was positively correlated with the daily concentration of atmospheric PM2.5,PM10,CO,NO2,SO2 and air pressure,but was negatively correlated with the daily concentration of O3 and daily average temperature.7.The single-contaminant model showed that the effect of atmospheric PM2.5 on residents’ admission to the respiratory system reached the highest on Lag5,and the risk of hospital admission for respiratory diseases increased by 0.6%(95%CI:0.1%,1.2%)with 10 μg/m3 increased in atmospheric PM2.5,which was statistically significant(P<0.05).The impact between PM10 and admission of respiratory diseases has not been found in this study.8.We built a multi-pollutant model based on the single-contaminant model,the results showed that after adjusting the atmospheric NO2,O3,NO2+O3 into the model,the risk of hospital admission for respiratory diseases increased by 0.9%(95%CI:0.1%,1.6%),0.7%(95%CI:0.0%,1.4%),0.9%.(95%CI:0.2%,1.6%)with 10 μg/m3 increased in atmospheric PM2.5,respectively,with were statistically significant(P<0.05).9.The results of stratified analysis showed that for every 10 μg/m3 increased in atmospheric PM2.5,the impact on admission of respiratory diseases in male residents was statisticall,y significant at Lag2,and with 10 μg/m3 increased in atmospheric PM2.5,the risk of hospital admission for respiratory diseases increased by 1.0%(95%CI:0.1%,1.9%);≥60 years old population had statistical significance at lag5,the risk of hospital admission increased by 0.70%(95%CI:0.0%,1.50%);non-smokers had an effect at lag5,the risk of hospital admission increased by 1.2%(95%CI:0.4%,2.0%);The diabetes group had an effect at Iag5,the risk of hospital admission increased by 1.9%(95%CI:0.1%,3.8%);The group with hypertension in the lags group,the risk of hospital admission increased by 0.8%(95%CI:0.0%,1.6%);The admission group in the heating period had an impact at Iag5 and the risk of hospital admission increased by 1.6%(95%CI:0.4%,2.7%).COPD group the risk of hospital admission increased by 0.7%(950%CI:0.2%,1.2%),and the pneumonia group was the risk of hospital admission increased by 0,7%(95%CI:0.1%,1.3%).Conclusion1.During 2015 to 2017,the air pollution in Tiexi,Shenyang was the most serious in 2015.The atmospheric PM2.5 and PM10 were the main pollutants.The concentration in winter and spring was higher than that in summer and autumn,and the concentration decreased year by year.2.Atmospheric PM2.5 has a certain impact on the admission of residents with respiratory diseases,and has a lagging effect.The optimal lag period for the general population is Lag5,and the optimal lag period for group with different characteristics is different.The effects of PM10 on respiratory diseases have not been discovered.3.There is a synergistic effect between atmospheric PM2.5,O3 and NO2 on the hospital admission of residents with respiratory diseases.4.Enhancing the personal protection of atmospheric PM2.5 of the group who are elder than 60 years old,with diabetes,high blood pressure,drinking history,and non-smoker can reduce the risk of hospitalization for respiratory diseases,and it is effective to strengthen the awareness of atmospheric PM2.5 protection during heating period. |
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